Mark Bertolini, president of Aetna, kicked off the HIMSS 2014 conference in Orlando on Feb. 24 with a speech about how to fix the current U.S. health care system. He believes a good system is economically viable and revolves around productive individuals who are satisfied and happy. "Yet our systems here and around the world are not functioning that way," he said.

It is well-known that U.S. health care costs are continuing to rise. A 2009 IOM study reported that 30 percent of that spending is wasted on unnecessary services and administrative costs. However, if that problem is solved, the government could pay back half of its debt in 10 years.

"This should be the focus of our efforts, this should be the focus of our policies, our solutions and our IT — how do we get at this waste," said Bertolini.
Additionally, chronic diseases are becoming more prevalent, GDP is increasing and health care premiums are growing four times more than inflation and wages.

Bertolini thinks that the health care system that was created in 1945 is no longer working. In order to get it on track, he outlined what he called "three prescriptions for how we think about a new foundation for health care." These include economic incentives that are aligned around ensuring patient health, making sure the chronically ill are taken good care of and investing in wellness for the next 25 to 30 years.

The current system also needs to revolve around the patient with simple ways to get the patient involved, he said.

"Mr. Bertolini was right on target with where health care needs to go," said Dr. Diane Homan of Rush-Copley Medical Center, who attended the keynote. "Engagement of patients is crucial, however you cannot engage a patient until they have access to the information and data they need to take care of their own personal health."

Digital tools are key, according to Bertolini.

"The system needs to change to focus on these individuals and get them to health systems, doctors and hospitals that will make them better," said Bertolini. "We know it works, it needs to be connected through technology."

He believes care needs to move away from the highest cost service such as doctor's offices and ambulatory services and move to the home where care can be provided at the lowest cost. "The only way we can enable that is through stuff you people in this room do, creating technology," he said.

Aetna, for example, is currently working with Medtronic to focus on vessel impedance, to try to catch water weight gain before it happens. Another application the insurance giant offers customers aims to help them make appointments, but also tells them where they can get a flu shot. "The whole idea is that more productive individuals are economically viable and they're satisfied," Bertolini said.

Before he stepped off stage, he had one request for the audience. "I challenge all of you to help me build a technology platform that enables this technology," he said. "It's about this type of solution, not the technology itself that makes a difference."

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